Physician Focus: The evolution of health IT

Wednesday

May 30, 2012 at 12:01 AMMay 30, 2012 at 12:07 PM

Information technology –– the use of computers, other electronic devices and software designed to support clinical decisions –– is now becoming a pervasive and critical part of health care delivery for the benefit of both physicians and patients.

Dr. Thomas Sullivan and Dr. Hugh Taylor

Technology has increased productivity, reduced costs and led to better services and products for most industries and professions, but health care is just beginning to catch up.

Information technology –– the use of computers, other electronic devices and software designed to support clinical decisions –– is now becoming a pervasive and critical part of health care delivery for the benefit of both physicians and patients.

Diagnostic technology, such as MRIs (magnetic resonance imaging) and CAT scans (computed axial tomography) have been around for a while and are wonderful tools to help us look inside the human body and diagnose and pinpoint conditions.

Technology in healthcare, however, has now progressed to allow for such advancements as electronic health records (EHRs), electronic prescribing and even telemedicine –– tools that can improve care, reduce medical errors, help to reduce costs and put patient information at the provider’s fingertips.

This new area of health information technology, or health IT, is considered so important today that the Federal government is providing incentive payments to health providers to adopt these new tools, and health policy makers, licensing organizations and even state governments are starting to establish competency requirements.

Health IT is still developing, however, and some physicians, particularly those in small practices, are wrestling with its inception: the cost of introducing it into a practice can be daunting, and learning how to use it and transferring patient information can be time-consuming. Further, the lack of interoperability –– the ability of systems used by different hospitals or different physician practices to talk to each other –– is often nonexistent.

Despite its growing pains, health IT has many advantages. Electronic health records, for example, let a physician quickly search through a patient’s past history to look for such things as drug allergies, prior conditions or prior test results and treatments. The ability to access information online brings added benefits. As many patients go to multiple doctors, physicians can quickly discover what drugs the patient’s other physicians are prescribing. Such information can prevent serious drug interactions.

E-prescribing, as another example, allows for two-way communication with the pharmacist, who doesn’t have to struggle with a physician’s poor handwriting –– historically, a problem that can lead to delays, misunderstandings and errors. Two of the biggest benefits to e-prescribing are that it has cut prescribing errors dramatically and presents alternative, lower-cost medications for a physician to consider prescribing. It also permits a patient’s question about insurance coverage to be answered quickly. E-prescribing is fast becoming popular; its use grew by 75 percent in 2011.

Health IT can also help ensure that patients get the kind of care they know they should be getting on a regular basis. A diabetic patient, for example, requires regular checks such as eye exams, blood tests and other measures. By setting up “alerts” or “reminders” on a computerized system, a physician can quickly know when the patient is due for screenings or tests and remind him or her to see that those are done on time.

Another growing area of health IT, especially useful in rural settings where health care providers may be in short supply or patients may live great distances from clinics or hospitals is telemedicine, where physicians and patients interact via webcams or videoconferencing. It’s particularly cost-effective for specialty consultations.

Health IT offers great benefits, but concerns about privacy, confidentiality and security are valid. While some breaches have occurred, those areas are paramount responsibilities for providers, and most systems are protected with multiple protocols and safeguards and continue to be updated with the latest security and policy changes.

Patients should remember, however, that technology cannot replace the human interaction between physician and patient. These tools may enhance care, but the computer, tablet or other electronic device should not be allowed to alter the physician-patient relationship.

So, if at your next visit you find your doctor staring into the computer more than you find comfortable, don’t hesitate to remind him or her that although you recognize the value of these new tools, you also value the eye-contact and one-on-one communication that makes this relationship special.

Physicians and patients are welcoming the advantages health IT brings, and rightfully so, it should make medical care safer, better, and less expensive. For more information, visit www.healthIT.gov. For a video discussion, visit www.physicianfocus.org/healthIT

Thomas Sullivan, M.D., a cardiologist in Salem, Mass., and Hugh Taylor, M.D., a primary care physician in Hamilton, Mass., are members of the Massachusetts Medical Society’s Committee on Information Technology. Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org.